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      • KCI등재

        쇼크 환자에서 비침습적인 심박출량 측정

        김오현,김현,이강현,황성오,최한주 대한응급의학회 2010 大韓應急醫學會誌 Vol.21 No.5

        Purpose: Invasive determination of cardiac output (CO) is possible via a pulmonary artery catheter but catheter implantation has risks. Clinicians can assess CO safely using a non-invasive cardiac output device such as a commercially available doppler system (ultrasonic cardiac output monitor, USCOM, USCOM Ltd, Australia) or using impedance cardiography (ICG). The purpose of this study was to investigate the consistency of hemodynamic measurements between ICG and USCOM in shock patients. Methods: From June 2007 to October 2007, we prospectively evaluated 21 patients with shock, who visited our emergency center. We measured CO and systemic vascular resistance (SVR) using ICG and USCOM on arrival, and at 30, 60, 90, and 120 minutes. Results: The mean difference in CO between ICG and USCOM was 1.08±2.13 L/min. The percent limits of agreement (LOA) were -60.0 to 84.7% between ICG and USCOM. The correlation coefficient for CO between ICG and USCOM was 0.76 (p<0.01). CO values measured by ICG and USCOM were 4.3±1.7 vs 5.9±3.9 initially, 4.8±2.2 vs 6.0±3.9 at 30 min, 4.3±1.6 vs 5.1±2.9 at 60 min,4.2±1.6 vs 4.9±2.7 at 90 min, and 4.1±1.6 vs 5.0±2.9 at 120 min, respectively. Statistical significance was observed within each modalities (p=0.03) but we did not find statistical significances between the two modalities. SVR (dynes*sec/cm5) values were measured by ICG and USCOM on arrival, and at 30, 60, 90, and 120 minutes. No statistical significance was seen within and between study groups. Conclusion: ICG and USCOM do not show clinically acceptable agreement.

      • KCI등재

        외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와 뇌손상의 정도 및 예후의 관계

        김오현,이강현,윤갑준,박경혜,장용수,김현,황성오,Kim, Oh Hyun,Lee, Kang Hyun,Yoon, Kap Jun,Park, Kyung Hye,Jang, Yong Su,Kim, Hyun,Hwang, Sung Oh 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2

        Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

      • KCI등재
      • 상사와 부하의 성격적합이 리더십 유효성에 미치는 영향에 관한 연구

        김오현,주수호 한국에니어그램학회 2009 에니어그램연구 Vol.6 No.2

        본 연구는 개인의 성격 간 특성 분석 및 상호작용을 규명함으로서 성격의 상호보완, 고유성격의 변화, 성격과 성격의 적합관계 그리고 리더십 유효성과의 연계성을 밝히는데 본 연구목적을 두고 있다. 이를 위하여 사람이 지닌 성격적 측면의 복잡성과 역동성을 이해하기 위하여 에니어그램의 성격적합 관계를 이용하였다. 본 연구의 연구결과를 요약하면 첫째, 성격유형별 선호성격 분포에서 군 조직의 구성원들은 에니어그램의 하모닉 그룹 중 긍정적 태도 그룹의 성격유형을 선호하였다. 이는 삶의 밝은 면을 강조하고 긍정적 생활 태도를 제시해 주는 리더를 선호하고 있음을 나타낸다. 둘째, 성격적합은 리더십 유효성과 긍정적 영향관계를 보였다. 본 연구에서 주목한 점은 성격적합에 있어 상호 보완적 성격 역할이다. 연구의 결과를 통해 조직 내 다른 구성원과 서로 보완적인 성격 조화를 통해 조직에 더욱 긍적적인 효과가 나타날 수 있다는 시사점을 찾을 수 있었다. 셋째, 성격의 발달방향과 리더십 유효성과의 관계를 통하여 인간이 지닌 성격의 복잡성과 역동성을 고찰하였다. 또, 상사와 부하 모두가 성격의 발달방향이 건강성을 지닌 통합 방향으로 향하고 있을 경우 리더십 유효성이 유의미하게 나타났다. 이는 리더로서 자신 및 부하의 성격을 분열의 방향이 아닌 통합의 방향이 되도록 관리하고 지도해야 함의 중요성을 보여주고 있다.

      • KCI등재

        흰쥐의 비마취하 요역동학검사에서 Prostaglandin E2를 이용한 과민성 방광 모델의 가치

        김오현,김룡호,윤상민,이택 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.6

        Purpose: Establishing an appropriate animal model is essential for investigating the yet unknown mechanisms of overactive bladder(OAB). Prostanoids are an already well known intrinsic cause of overactive bladder in both animal and human. Awake animal models with prostanoids are already being used as an OAB model, but there is no standardization of methods, and especially for the concentration of the administrated prostanoids. So in this study, we tried to objectively establish the standardized concentration of prostanoids and its effect on urination through urodynamic studies with using non-anesthetized Dawley rats. Meterials and Methods: We divided 18 female rats(215-280g) into 3 groups of six rats each and we injected 30μM, 50μM or 100μM of PGE2, respectively. A catheter was placed inside the bladder through an incision in the abdominal wall. After three days, cystometry was performed with the arts in an awake state. During cystometry, we administrated saline into the bladder to identify the usual voiding status of the rat. In comparison, the saline with PGE2 at 3 different concentrations(30, 50, 100μM) was administrated into the bladder(10ml/h). Results: Each group of the 30, 50, 100μM PGE2 administered rats showed an increased level of the basal pressure, the threshold pressure and the maximal pressure compared to the state before administration of PGE2. Also, the bladder capacity, voided volume and micturition interval decreased by a statistically acceptable amount, like was seen in the OAB model. There was a trend that showed a greater increase in the pressure parameters and a greater decrease in the volume parameters in the 50μM PGE2 group compared to the 30μM PGE2 group, but there were no differences between the 50μM and 100μM groups. Conclusions: In the normal awake rats, PGE2 induced overactive bladder to a statistically significant amount for all concentrations(30, 50, 100μM). Among these groups, the concentration of 50μM provoked OAB most effectively, and the higher concentration of PGE2(100μM) did not provoke a more efficient OAB, which might have been due to the characteristics of the intrinsic material in the bladders. Thus, we recommend PGE2 50μM for efficient induction of OAB. (Korean J Urol 2008;49:526-532) Purpose: Establishing an appropriate animal model is essential for investigating the yet unknown mechanisms of overactive bladder(OAB). Prostanoids are an already well known intrinsic cause of overactive bladder in both animal and human. Awake animal models with prostanoids are already being used as an OAB model, but there is no standardization of methods, and especially for the concentration of the administrated prostanoids. So in this study, we tried to objectively establish the standardized concentration of prostanoids and its effect on urination through urodynamic studies with using non-anesthetized Dawley rats. Meterials and Methods: We divided 18 female rats(215-280g) into 3 groups of six rats each and we injected 30μM, 50μM or 100μM of PGE2, respectively. A catheter was placed inside the bladder through an incision in the abdominal wall. After three days, cystometry was performed with the arts in an awake state. During cystometry, we administrated saline into the bladder to identify the usual voiding status of the rat. In comparison, the saline with PGE2 at 3 different concentrations(30, 50, 100μM) was administrated into the bladder(10ml/h). Results: Each group of the 30, 50, 100μM PGE2 administered rats showed an increased level of the basal pressure, the threshold pressure and the maximal pressure compared to the state before administration of PGE2. Also, the bladder capacity, voided volume and micturition interval decreased by a statistically acceptable amount, like was seen in the OAB model. There was a trend that showed a greater increase in the pressure parameters and a greater decrease in the volume parameters in the 50μM PGE2 group compared to the 30μM PGE2 group, but there were no differences between the 50μM and 100μM groups. Conclusions: In the normal awake rats, PGE2 induced overactive bladder to a statistically significant amount for all concentrations(30, 50, 100μM). Among these groups, the concentration of 50μM provoked OAB most effectively, and the higher concentration of PGE2(100μM) did not provoke a more efficient OAB, which might have been due to the characteristics of the intrinsic material in the bladders. Thus, we recommend PGE2 50μM for efficient induction of OAB. (Korean J Urol 2008;49:526-532)

      • 齒科醫師 需要와 供給에 關한 硏究

        金午鉉 서울大學校 保健大學院 1969 公衆保健雜誌 Vol.6 No.1

        From the study to decide data needed for setting a long term plan of supply of dentist, following conclusion is drawn. 1. From the current status of supply and demand of dentist, it was anticipated that deficiency of supply of dentist would be 710 in 1976 and 1,590 in 1986. Under the presupposition that the medical insurance system had taken effect by 1986, the deficiency of supply of dentist, however, should be expected to be 3,090 by the year. 2. In the year 1967 number of licensed dentist, was 1,843. Among them 85 per cent was dental college graduate and 15 per cent was those who passed qualification examination without college professional education. 3. Private practitioner occupied 68 per cent of all dentist, while 17 per cent was in military service. 4. Distribution of dentist through the classification by urban and rural area revealed that 84 per cent proved to be in urban area. 5. Migration rate of dentist between urban and rural area was more than 24per hundred, and most of the migration was from the rural area to urban area. 6. 70 per cent of licensed dentist without work was under age of 39. 7. Estimated number of dentist in 1967 is 1,450 that of 1976 is 2,290 and by 1986 it is expected to reach 3,010. 8. As most dentist is omnipresent in urban area, the possibility that demand of dentist in rural area is fullfiled by unqualified dentist seems to be great. Giving consideration to the situation, demand of dentist in 1976 would be calculated at 3,000 including 1,500 dentists of rural area, and that of the year 1986 to be 4,600. On the other hand when the medical insurance system carried into effect by 1986 as government plans and discrepancy of medical services between area to area should be balanced, the demand of dentist would be estimated to be 6,100 in 1986.

      • KCI등재

        Effect of post-treatment fluvastatin for hemorrhagic shock in rats

        김오현,김수기,정순희,황성오,김 현,차경철,차용성,안교진,이강현 대한응급의학회 2022 대한응급의학회지 Vol.33 No.5

        Objective: This study aimed to investigate the biochemical, histologic, and immunologic effects of post-treatment administration of fluvastatin in a hemorrhagic shock (HS) rat model. Methods: Experimental rats were randomly divided into four groups: control group: no drugs and did not undergo HS; control statin group: fluvastatin 1 mg/kg (no HS); HS group: normal saline after HS; HS+statin group: fluvastatin 1 mg/kg+normal saline after HS. Briefly, HS was induced by femoral arterial catheter blood extraction of 30% of the total blood volume. The mean arterial pressure and heart rate were monitored for 2 hours after starting blood withdrawal. Arterial blood gas, complete blood count, and serum cytokine levels were measured at baseline, 2 hours after HS, and 48 hours after resuscitation. The kidneys, lungs, and small intestines were removed for pathological examination 48 hours after HS. Results: At the end of the resuscitation period, the HS and HS+statin groups showed reduced bicarbonate, base excess, and platelet counts, all of which differed significantly from values in the control and control+statin groups. Compared to the control group, the HS+statin group exhibited significantly elevated serum interleukin-10 (IL-10) at 2 hours after resuscitation (P<0.05). Except for IL-10, the group-time interaction was not significant for other cytokine profiles. Conclusion: This study demonstrates that post-treatment with fluvastatin after HS increases the production of the antiinflammatory cytokine IL-10 and affects the cytokine profiles in rats.

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